Browsing: Healthcare Systems

Like every other sector, the healthcare system is also evolving and becoming complex. In this respect, care planning and management are necessary for leading a smooth present and a better future. Healthcare planning is important not only because it assures a safe future but because these kinds of services are getting expensive. Also, a good health sector is a part of nation's development that resembles the government's approach to keep its citizens happy and healthy. The Care Quality Commission (The CQC) is an initiative with a vision to provide the best health services to the users of the healthcare system. The CQC regulated health and management units assure that their services meet the essential standards in terms of safety and quality.

Availing domiciliary or residential health care services is not a difficult thing to get if there are planning and finance. However, with this sector growing with pace, choosing a reliable service provider can be a daunting task. Be it adult care, child care or care for the people with disabilities, there are certain fundamental standards that the care providers must fulfill, in order to successfully complete registration with CQC registration form.

The following are some basic factors the social care providers must consider to become a CQC approved body:

Personalized Care:

The care provider must ensure that people using their service must receive quality treatment. Other than superior quality services, the care provider must provide care or treatment that is person-centered or personalized for specific individuals. According to CQC regulation, the service body must ensure that each person availing the service must receive proper attention based on their needs and preferences.

Respect the Concerned People:

One of the key considerations of any social care service provider is that it must treat the concerned people with dignity and respect. People who have approached the service provider are in need of special care. Therefore, it is the duty and responsibility o the caregivers that they must treat the persons with dignity without hearting their sentiments and gives them the privacy they desire.

Should Not Function without Consent:

Another very important attribute of a good care provider depends on their work ethics. Consent is important in every phase of care providing. The provider who does not communicate well with the people receiving the care or any person on their behalf is not their sign of professionalism.

Safety and Security:

Safety is one of the most critical concerns of a social care provider. Only promoting high-quality service can not make a service provider reliable. Keeping the people safe and secured from every aspect is important. Safety does not only mean life risk but safety in different phases. It may be in terms of using safe equipment for care or providing healthy nutrition. Any decision taken by the providers must ensure the welfare of the people.

Protection from Abuse:

Care services are for people who need special treatment. Provides must have a robust set of rules to prevent people using the service. They must take necessary step incase abused by staff, visitor and even any expert offering the service. Be it a threat, physical abuse or anything that restrains the liberty provides must take such things on a serious note.

The Room for Complaints:

The sign of a trustable care provider is one who considers the complaints in an optimistic way and takes all the necessary steps to rectify their flaws. There must be a special set of ruler where people availing the service get a chance to complain about the differences, problems that they are facing in the care home or by the care provider. All complaints must undergo thorough investigation and productively come with solutions.

The above factors are some of the basic activities that a reputable care provider with CQC registration will perform. They ensure that the person availing the service will receive the best treatment.

Permanent factors such as nutritional deficiencies, seasonal migration, erratic meal timings and a myriad of other factors elucidated in my earlier blogs that result in the proliferation of malnutrition in the tribal villages and districts, the issue of malnutrition can reliably be easily controlled to a great sufficient with adequate delivery of healthcare services and provision of affordable and accessible healthcare in the tribal areas. I will touch upon the major aspects of tribal healthcare services, its links with the issue of malnutrition and inherent restrictions of the same to counter the issue. In the process, I have also made an attempt to make some suggestions with respect to each of these factors that contribute in the spreading of malnutrition.

Tribal Hospitals – Links to nutrition

Most tribal hospitals can prove to be lifesavers with respect to the life threatening health problems faced by tribals in the villages in Maharashtra and elsewhere in India. The single largest factor that leads to malnutrition is the lack of proper food and nutrition. Part of the problem is also the lack of awareness regarding the importance of balanced diet and other daily diet and nutritional requirements. For this, though, if the tribal hospitals in these regions can be equipped with a nutrition rehabilitation unit, then a very critical source of this life threatening issue can be curved. The nutrition rehabilitation units could help address the nutritional imbalances in the daily food intake of the tribal population suffering from malnourishment. The purpose of these nutrition units could be to dole out special therapeutic foods that contain macronutrients such as proteins, fats and carbohydrates and also very important micronutrients such as the essential vitamins and minerals. The therapeutic food can be made from local food sources and using local manpower itself. In addition to this, the primary health center (PHC) too must be equipped with specialized child treatment treatment centers that provide this essential therapeutic diet to the malnourished (target) population.

Paucity of Primary Health Centers

Primary health center (PHC) or public health center is the backbone of healthcare service delivery in India, especially urban slums and rural areas. PHCs are the basic structural and functional unit of public health services. The main objective behind a PHC is to provide accessible, affordable and available primary healthcare to the rural population. The numbers of PHCs in rural India and especially in tribal areas are themselves not adequate. At present, there is only one PHC serving approximately 35,000 tribals, on an average. The lack of adequate number of PHCs relative to the tribal population in these areas is quite alarming. In an ideal situation, one PHC can serve a population of around 10,000 people only and covering an area of ​​5-8 kilometers, at most. However, at present, a tribal has to travel up to 20-25 kilometers to reach the nearest PHC.

The State government must ensure adequate number of PHCs at an approximate 8-10 kilometers radius of the tribal village. CHCs (Community Health Center) and PHCs need to be made more accessible for the villagers. In case a specialized CHC and PHC can not be detected at all the required locations, then the Government must ensure at least one health sub-centre in all the tribal villages.

Non-availability of Doctors and Nutrition experts

Even with these PHCs in place, healthcare service delivery in tribal areas faces other major problems. That is, extreme shortage of medical personnel. Medical doctors, nurses, nutrition experts and other medical personnel are unwilling to relocate to tribal areas in order to practice medicine and serve the tribals. In the tribal belt of Maharashtra, the doctors are not ready to go and work in the hospitals in these areas. So, most of the hospitals in the tribal areas remain under-staffed most of the times. There is particular scarcity of maternal and child health (MCH) specialists and other medical specialists such as pediatrician, nutritionists, anaesthetics, among others, in the tribal hospitals. Further, due to severe lack of pediatricians in government hospitals and PHCs in such tribal areas, if the infant / child is suffering from chronic malnutrition, the risk of the child succumbing to death during the first 1,000 days (of birth) increases manifold. Thus, there is definitely a strong correlation between lack of trained medical specialists and malnutrition deaths.

We are well aware of one of the age-old superstitions related to pregnancy and food intake. That is, the tribal women follow the practice of low food intake during pregnancy for easy and comfortable delivery of the newborn (resulting in anemia among mothers and malnourishment among the infants). The intake of nutritious diet is the least among women when they actually need the most!

Another critical hurdle that healthcare faces are that the local population usually does not want to admit their children to hospitals due to superstition, cultural barriers and various other socio-economic factors. Since these tribals often do not admit their malnourished children to hospital, children are dying at home.

The state governments can possibly start a home based 'Child Healthcare Program'. For instance, I think the government of Delhi has done well by introducing Mohalla clinics . This is a very clear signal of why primary healthcare must be delivered as close to home as possible.

In such aforementioned programs, the relevant malnutrition cases can be treated in the comforts of their home and village by a trained female health worker. This female health worker could focus on special healthcare needs of a pregnant woman; help provide ante-natal care (ANC), post-natal care (PNC), provide guidance and assistance to young mothers, newborn and infants. Perhaps, the Maharashtra Government can start such a program wherein all the underserved rural areas, especially the tribal areas, are provided essential maternal and child health care facilities. Here, government health officials and staff such as the Accredited Social Health Activist (ASHA) workers, Integrated Child Development Service (ICDS) scheme workers, Auxiliary Nurse Midwives (ANM), among others, can be roped in to provide such dedicated and specialized care to the focus groups.

Furthermore, health counsels can be roped in to promote and promote the provision of institutional deliveries. The counselors can ensure 24 hour care and counseling services, especially in the most underserved tribal regions. The state Governments can invest and develop such 'Health Counseling Programs' through the support of local Non-Governmental Organizations, etc. This will further ensure affordable, accessible and equitable health care delivery among the rural and tribal populace.

Government Failures – Under-reporting of malnutrition cases

Under reporting of malnutrition and child deaths is a very big issue. The average Infant Mortality Rate (IMR), that is, the number of child deaths per thousand live-births, is close to around 60 in all tribal areas. But this is reported as less than 40. Similar condition is for reporting of the severe acute malnutrition (SAM) cases. The prevalence of SAM is approximately 20% of the total malnourished children, which is very high. But as per government figures, it is regularly reported as less than 10%! In essence, suppose there are 1000 children who are severely malnourished, but only half of them are reported as SAM cases. The remaining (estimated around 50 percent) children suffering from SAM so get excluded from specialized care and treatment, if any. These are essentially the 'missing SAM' cases. These excluded / missing / neglected children are thus more prone to succumbing to death in the absence of the much needed care.

Thus, correct statistics, correct recording of the facts and figures and correct reporting can go a long way to at least move in the right direction and thenby to resolve the severe malnutrition prevalent in these tribal areas. This will ensure proper planning, implementation and implementation of targeted treatment and care for both the strictly and moderately acute malnutrition cases in the tribal villages.

In conclusion, I would like to lay greater emphasis on the present health systems in place at the central, state, village, and district and block level to work in tandem rather than independently. There is a dire need to strengthen the links and synergies of all major holders of heath care in India, especially in the most underserved rural and tribal regions of our country. The State government needs to commit greater investments towards the tribal healthcare ecosystem. Tribal hospitals need to be equipped with state of the art facilities, focussing especially on the most vulnerable sections of the society such as the young mothers, pregnant and lactating women (PLW) and newborn and infants and children below the age of 5 years. Furthermore, there is an urgent and persistent need to devise formal behavior change communication (BCC) and community mobilization (CM) strategies by the CHC, PHC and health sub-centers to comprehensively address the cultural barriers prevalent among the tribal population.

Lastly, relationships between tribal cultures, behaviors, government interventions (such as subsidies), health system and policies and malnutrition need to be studied in detail. The solution to address such a huge problem like malnutrition can not be generalized. That is because the demographics of the tribal community very dynamic and varies region wise. Thus, focussed ingenuous interventions need to be carried out at the micro level, specific to that very district, that very block and that very village or hamlet.

According to the 2011 census, India is affiliated by 104 million people classified as tribals (ie, 8.6% of the country's population) associated to over 550 tribal communities and approximately 277 ethnic groups. Tribal communities have collectively submitted themselves to the forest setting and as a result of living so close to nature have, over the years, acquired a unique knowledge about the use of local resources. Given they hold precious knowledge on the specific use of a large number of wild plants one could almost consider them as the real custodians of medicinal plants. There is a growing understanding of the pivotal role medicinal plants play in providing herbal remedies to health maladies. According to a study conducted by the All India Coordinated Research Project on Ethno-biology (AICRPE), over ten thousand wild plant species are reported to be used by tribals for meeting their primary health as well as food requirements. Further, there are approximately eight thousand medicinal plant variants utilized by over two million traditional healers for treating ailments of both humans and livestock. Traditional medicine bequeathed from generation to generation is rich in domestic recipes for common health ailments. The best known examples of traditional medicine, different in concept and protocol, are well developed systems such as ayurvedic and herbal treatments that have been widely used to sustain human health, especially in tribal regions of India.

3. Pathari – For ichthyosis (scaling of skin), xeroderma (dry skin). The roots are crushed and the extract is used

4. Kadu kand – Well cooked bulb slices can be consumed to get relief from stomach ache whereas paste of heartwood is used to cure wounds

5. Tetu – It is administered to women to treat leucorrhoea and menorrhoea

Traditional Medicine – Links to Maternal and Child Health

Traditional medicine is critical and has contributed tremendously to the healthcare of both the mother and the child in tribal regions. Jawhar block in Palghar district, Maharashtra is a tribal block having rich biodiversity, especially rice varieties having specific characteristics and uses. The tribal farmers have cultivated diverse rice varieties for purposes such as food security, instant energy provision during peak workload and medicinal use. This wonderful diversity of rice has formed the basis of a nutritious and secure diet for the vulnerable groups of the tribal population, that is, mothers, pregnant and lactating women and young children.

Various ongoing studies conducted by the NGOs such as BAIF Development Research Foundation in different tribal belts across Maharashtra found a number of rice varieties having specific medicinal properties and uses. For instance, one rice variety called 'Mahadi' has multiple health benefits; one of them is to cure weakness in women post pregnancy. Other rice varieties include Rajghudya and Kali Kudai (used to increase breast milk in lactating women); Kali Khadsi (for child's growth and nutrition); Kasbai (used for nebulization, which gives instant relief from cough) and Dangi (used for instant energy boost), among others.

Furthermore, traditional kitchens, serve as an in-house medical supply store. Tribal regions lack proper health centers. Thus, most of the child deliveries take place at home and not in a hospital. The rate of institutional deliveries is slowly increasing but there is still a long way to go for this to become a rule, rather than an exception. Since most of deliveries take place at home, the traditional birth attendants play a major role in tribal regions. One of the practices performed by the birth attendants in villages is to use materials like cow dung as a disinfectant in the house that helps keep various diseases at bay. The various homemade medicines, mostly herbal, for the mother and child are also prescribed predominately. Restoring the mother to her original physiology is a challenge that the native healers often take up.

Habitat Loss – A Threat to Traditional Medicine

An impending threat to further proliferation of traditional medicine is the rampant loss of habitat. Unregulated harvesting of wild produce coupled with ecological degradation leading to intensive resource depletion and tribal landlessness (and even those who do land are continuing losing their land to the government or private corporations) are some of the factors posing a grave and growing threat to the conservation of indigenous foods and traditional medicinal plants.

Furthermore, there has been a gradual erosion of indigenous varieties, especially rice biodiversity. Most of the indigenous rice varieties are being replaced by high yielding varieties. These high yielding varieties have not responded in any spectacular increase in yield in this region. The majority of farmers, especially the resource-poor tribal farmers are not able to afford high quality expensive fertilizers which are normally recommended along with these varieties.

In addition to the above, there has been a gradual loss of practical knowledge about traditional medicine and healing practices in the tribal regions, during the past couple of decades. This has resulted in poor health status of the most vulnerable sections of the tribal population. Many factors contribute to this knowledge erosion. The most pressing issues relating to this knowledge are: a) lack of incentives and recognition. For instance, scientists and researchers collect data and publish their studies but often fail to give the due recognition to the healers. Also, the ayurvedic and allopathic drug companies extract knowledge for research and development purposes, but do not usually share profits with the tribal healers; b) lack of proper documentation of knowledge relating to traditional healing practices; and c) broken intergenerational links (impacting discrimination of age-old knowledge and traditions from older generation to the younger generation), among others.

Tribal healers are known to use their own systems of healthcare with plant and animal extracts. However, in the recent past, factors such as aversion to follow the low income traditional healing practices; gradual shift to more lucrative alternative livelihoods; greater reliance on non-traditional healing practices and high degree of inroads by modern medicine, is threatening the traditional medicinal traditions to proliferate further. The native tribal healers are precious, but, still remain a neglected lot.

Traditional medicine is critical as well as cost-effective (in relation to hospital care) and ensures self dependency on healthcare due to enhanced reliance on the local biodiversity. It must be given the much needed boost.

Further, majority of the traditional healers lack legal authority to heal. Herbal healers need to be identified and honored. These unsung heroes need to be brought into the fold of the formal healthcare system of India so that unhindered services are made available to the needy in the villages. Further, weeding out unqualified healers is equally important. These healers provide their services to the most interior and under-served tribal regions. Thus, appropriate regulations and government policy actions and support would help streamline traditional healing practices.

With the state administrated healthcare systems based on modern medicine unable to tackle the mammoth health challenges in the country coupled with the acute shortage of resources and well trained health personnel to effectively implement each and every one, it is imperative to get traditional healing practices back on wheels. Traditional knowledge sharing, conservation of the rich biodiversity and enhanced focus on tribal healing practices through greater recognition to the traditional healers and thus securing their livelihood is the need of the hour. Furthermore, providing much needed impetus to the time tested traditional medical practices is pertinent for ensuring better healthcare of all sections of the society, especially the most vulnerable section in the tribal belts of the country.

A patient of Dr. T, an orthopedic surgeon, recently visited his office because the knee which he replaced seven months prior was still swapping and was painful at times. It was not like the first knee that he replaced for her, which was doing very well and was pain free. When she visited his office, he sat down near her at her level, as he has always done when she visits him in his office. He examined her knee and said that he sees that it is hot and swollen. He took an x-ray to make sure there is nothing wrong with the replacement knee. There was not. He then took a sample of the fluid on her knee, being sure that the knee is numb. He told her that he will have it sent to a lab for analysis. He will let her know what he finds. She is surprised when a few days later he personally called her with the results. He told her that there is no infection and goes on to explain that in his experience he has seen patients whose tissue near the surgery site holds tender for a while, causing swelling. He advised her that they should wait a while longer, a couple of months, as he thinks the issue will resolve itself by then. If not, he wants to see her again. She agreed because she trusts his judgment.

This is a real case. I use it here because it is a very good example of a physician being patient-centered and building trust with the patient. The patient responds positively to the physician because he has taken the time to build a positive, respectful relationship with her. He is empathetic with her situation.

This story is a very good illustration of the principle 'Seek First to Understand, Then to Be Understood', found in Stephen R. Covey's classic business book, The 7 Habits of Highly Effective People. When Covey discusses this habit (Habit 5 in the book) he talks about empathetic listening, an important skill for any clinician and anyone else who provides a service to others. Covey relates that 'communication is the most important skill in life.' We communicate through reading and writing, speaking and listening. Each of you has spent hours in school learning to read, write and speak. There is little formal education for listening! To truly communicate with anyone we must be able to listen well. To be able to interact effectively with anyone requires understanding that person. Covey says that there are four levels of listening-ignoring, pretending, attentive and empathic. Ignoring listening is not really listening at all; it is just being present. When we pretended to listen we say 'uh-huh' and do not care what is being said. Attentive listening recognizes what is being said but does not internalize anything. Empathic listening involves listening with the intent to understand the other person. There is no jurisdiction involved. You see the world as the other person sees it. This is the type of listening that the best clinicians use and which Dr. T uses.

Empathic listening builds trust in patients which is vital to engage them in their own care. You may reach this level of listening with your patients but the trust built can quickly be destroyed if you are careless when not in the patient's presence. Consider the following incident.

As a licensed practical nurse for more than 20 years, Bob knew the importance of safeguarding a patient's privacy and confidentiality.One day, he used his personal cell phone to take photos of Claire, a resident in the group home where he worked.Bob received permission from Claire's brother to take the photo since she was unable to give consent due to her mental and physical condition.That evening, Bob ran into William, a former employee of the group home.While catching up, he showed William the photo of Claire and discussed her condition with him.The administrator of the group home later learned of Bob's actions and terminated his employment for breach of confidentiality.

This incident is quoted from The Nurse's Guide to the Use of Social Media. The guide, which can be found for free online, discusses the limits of using social media to share information about patients. It states that because of HIPAA a clinician can not share information about a patient in social media where the patient can be identified. The only time any patient health information can be shared with another is when the other person is also caring for the patient or when there is a legal need to do so.

Consider another incident of misuse of identifiable patient data. A nurse was working at her station in a hospital. She received a phone call from her sister-in-law who said that she had just been admitted to the same hospital and would she visit her at her lunch time. The nurse agreed but forgot to take down the room number of her sister-in-law. When the nurse's lunch time came she logged into the hospital's computer system to find out the room of her sister-in-law. When she arrived at the room, she was met by hospital administrators who said that she had improperly accessed her sister-in-law's patient information. The nurse said she only looked at the room number and the sister-in-law vouched for her that she did not mind. The administration proceeded to terminate her for breaking patient confidentiality.

The Guide goes further in cautioning about the use of social media to discuss patients. It may be that a clinician or healthcare employee posts an item in a blog or Facebook page which has been protected to allow only friends to see the posting. This seems safe enough. It is not. Friends may repost such patient information in a public forum. A posting of patient information may be removed quickly from a site. However, the information is still on the internet server and is discoverable by hackers or through legal means. The Guide goes on to say that no information about a patient which could be identified with the specific patient should be posted anywhere in a public forum or online. Only de-identified information may be used.

In order to achieve the best results with patients it is necessary to be authentically engaged in listening to them, as Stephen Covey points out. Such engagement leads to a building of trust. This trust must be saved at all times. It only takes actions of carelessness or thoughtlessness to destroy such trust, as illustrated in the careless use of social media by caregivers or by the improper access to patient information by a clinician. Trust needs to be built and protected to have the best results. The best action for any caregiver or any service provider is to never share any personally identifiable information with any other without it is necessary for the care of the patient or improvement of service for the client.

Whether you are involved professionally in healthcare or not, I highly recommend that you read Covey's book, The 7 Habits of Highly Effective People.

Patients and healthcare providers across the globe have come to the realization that dependent solely on hospital systems will no longer be a viable option. Industry experts are of the opinion that ongoing interventions in home healthcare devices and services will help alleviate the current pressure on the global healthcare system.

Technology has proven to be extremely critical to home healthcare. Current and upcoming advances in home healthcare technologies are not only designed for effective disease control but also encourage and enable individuals to live independently.

Technological interventions were complex and expensive in the past. However, growing need and demand for convenient and effective remote patient monitoring, development of new and innovative technologies, and availability of sufficient funding have led to increased accessibility to low-cost technologies and devices.

The new and affordable in-house gadgets are not just popular among geriatrics looking to age at home. The customer base has rapidly expanded to include new patient groups, such as those suffering from chronic illnesses, children, and diabetics. This is sure to pave the way for a brighter future for both patients and healthcare providers.

Growing Use of Biosensors to Monitor Geriatric Health

When it comes to home healthcare for the geriatric, there are some innovative technologies and gadgets that have been seamlessly integrated into the assisted living or senior living industry, or in what is more broadly referred to as geriatric care services. Speaking from a strictly medical perspective, recent technologies for monitoring the health of senior citizens including blood pressure monitoring devices, oxygen therapy devices, patient temperature management devices, and cardiac monitoring and cardiac rhythm management (CRM) devices.

An article by NBC News sheds light on the growing adoption of sensor technology in the US, especially for senior living. Allowed for improved estimation of a patient or individual's metabolic state at a remote location, biosensors enable constant monitoring of those seniors who suffer from a number of different ailments but choose to live independently, out of hospitals and nursing homes. The NBC article discusses the use of such sophisticated sensors to track an elderly couple's walking speed, heart rates, and even sleep patterns. This unobtrusive technology also sends alerts in case of emergencies, allowing timely intervention of family members or caregivers. Like several medical device companies, research organizations, and medical universities, ElderTech, Missouri, has been studying the significance of environmentally-embedded in-home sensor networks and their relevancy in detecting health changes in older adults.

Development of Portable Digital Devices to Remotely Track Heart Conditions

As the medical devices industry undergoes a tectonic shift with the advent of telemedicine, the field of cardiology has also felt its ensuing benefits. Soaring incidence of cardiovascular conditions and the consequent need for constant monitoring of patients have resolved in demand for cardiac monitoring and cardiac rhythm management (CRM). Home healthcare is a leading end user of these devices, with demand for ECG and cardiac monitors, Holter monitors, event monitors, and ILR (implantable loop recorder) continuously rising.

Interviewing the founders of Eko Devices, The New York Times talks about growing competition in the telemedicine business. Eko is one of the many cardiovascular care companies that has been capitalizing on the home healthcare industry .

In a recent development, the company developed a digital stethoscope specifically catering to cardiac patients at home. This innovative palm-sized device, called DUO, has the potential to alter the way heart patients are monitored. Combining electrocardiogram or EKG and electronic stethoscope in just one device, DUO provides unpretented insight into cardiac functions. This includes tracking and quickly reviewing heart rhythms and sounds to enable advanced bedside analysis and, if required, remote care.

With medical devices becoming increasingly interconnected thanks to rising penetration of the Internet, growing use of smartphones and a slew of other medical devices, and expanding hospital networks, detecting and managing diabetes at home has become not only convenient but rather effective. Today, there are a wide range of diabetes devices available, promising quick and accurate results. User-friendly designs of most devices and increasing awareness levels along the diabetic population across the globe have been resolved in a rather massive market for self-monitoring devices to be used in home settings.

A recent research article sponsored and reviewed by Avantes BV – a prominant innovator in the development and application of miniature spectrometers, focuses on the need for non-invasive diabetes diagnosis and monitoring. In order to detect and treat diabetes before it gets out of hand, constant glucose monitoring and maintenance is critical, and for the longest time, existing diagnostic standards and therapies were immensely invasive. Moreover, managing this disease out of hospital settings was extremely difficult. However, advanced medical sensing technologies have enabled easy and non-invasive blood glucose monitoring and diabetes testing. Latest innovations have also ensured convenient and user-friendly insulin self-administration devices.

Wearable technology has been one of the most prominent innovations to benefit and empower diabetics around the world. These devices have been preventing diabetics to take charge of their own health outside the doctor's clinic and effectively managing the condition. Smartwatches, interestingly, have shown immense potential to enable needle-less glucose monitoring with time. Apple Inc. is reportedly working on developing sensors for monitoring of blood sugar levels, an advancement that could turn devices such as the Apple Watch into a means of monitoring important vitals. The aim is to develop sensors that can non-invasively and regularly monitor blood sugar levels to help diabetics treat the condition from the comfort of their homes.

Conclusion

An article in The New York Times recently shed light on the shrinking community of home health aides or personal care attendants in the US According to Paul Osterman of the Sloan School of Management at the Massachusetts Institute of Technology, if the number of workers in this field of home healthcare continues to fall, the country will be faced with a shortage of around 350,000 paid care providers by 2040. This alarming fact makes the development of advanced remote patient monitoring devices even more crucial.

Keeping this need in mind, companies are looking to devise technologies that will, in a way, replace human service providers with digital home healthcare assistants. To put this into perspective, home health aides are now testing Amazon's Echo platform as a home healthcare assistant. Researchers hope that the companion online app will be increasingly responsive to clients' needs, keep family caregivers in the loop at all times, and effectively streamline alerts, reminders, and functions.

This opportunity is sure to capture the interest of tech giants such as Google, Apple, and Amazon, giving them an opportunity to emerge as trailblazers in home healthcare.

Over the past 10 years the Western world has seen an unprecedented health IT transformation. Hospitals, as well as private clinics, have moved from the traditional paper-based systems to one where the patients have a digital record of their medical conditions and treatments. The enabler has obviously been a dramatic uptake of electronic health records (EHR / EMR).

According to data gathered in 2016 – over 95% of hospitals and nearly 80% of physicians in USA used EMR systems. The prevailing ecosystem is pushing both these numbers quickly even more close to the 100% mark. Only 7 years prior (2009), the data standing at – under 10% hospitals and 17% physicians using electronic medical records systems. Even though the primary push to these numbers was triggered by government legislation – the impact on society and medical fraternity is the main benefits.

In India – technology has rapidly changed our lives over the last decade. We have seen one of the most rapid adoptions of mobile and internet, and prices are among the lowest in the world. Even people living below poverty line consider mobile phone as a 'must have' – believing it to be an equalizer. On the other hand, however – the patient consultation process for a doctor remains large traditional (historical) – paper based. While all of us expect, and demand, banking, payments, tax filings, diverse information access, train, taxi, air and even cinema bookings over the internet, our expectations in the management of health – our most important asset – have been surpriously muted .

India has nearly 100,000 organized health setups – including government and corporate hospitals, health centers, and nursing homes of various sizes. India also has nearly a million private clinics. While many large hospitals, and government run health centers in some states, have installed systems to capture patient & prescription details, no one is even thinking of the unorganized healthcare sector – being catered to by the million or so clinics. The only thing available in the name of being 'digital' – for most metros and cities – is various doctor search sites and apps.

The core of digital healthcare, an electronic medical records system, that both doctors and patients have access to – a Public EMR – is simply not available. Is this something we can avoid for too long? Certainly not. Yes, there will always be people who consider letter writing as an act of ink hitting people – but rest of the world has moved to email and instant messaging. How quickly will healthcare go digital?

The present corporate sector is far more demanding and competitive than ever. Employees nowdays are expected to deliver timely and productive results throughout the year. To take care of the adhoc absenteeism related to sick leaves and to prevent any hiccups to achieve the business targets. It is essential to introduce employee wellness programs. The top most organizations have already set up such wellness programs within their organizations by introducing corporate health checksups. A healthy employee is a productive employee and a productive employee boosts the organization's success.

Best Ways to Develop a Healthier and Productive Workplace for Employees

You can build a healthy work culture for your employees in a smart and effective way. Introducing a comprehensive health model in a business practice can help employees stay healthy and deliver productive outcomes. Some of the ways that in line with developing a healthy work model are as follows:

1. Stress-management activities

Most of the employees suffer from work-related stress. As a result, they develop unhealthy habits, like drinking alcohol, smoking, and improper diet, like eating junk food or too much consumption of caffeine, etc. The Human Resource Managers should introduce stress bursting or playful activities in their work culture on a regular basis. Group activities, like playing any sports, yoga, meditation, zumba, aerobics, and others can help employees stay healthy and relaxed.

2. Transparent Communication

A positive and healthy work culture is only possible if the employee concerns and issues are addressed in time. The HR manager can plan weekly face-to-face sessions to ensure that employees are able to focus on work and deliver effective end-results.

3. Employee Counseling Sessions

There are various factors that might affect the productivity and health condition of an employee. The corporates can introduce counseling sessions for employees to educate them about benefits of good health and to guide them with resolutions. It is wise if such sessions are conducted by an expert counselor or a health expert.

4. Employee Medical Report

The Human Resource Manager can plan to maintain the health report of an employee. The same can be shared with the employee for updating him about his health status and if required the physician advises the employee on how the health condition can be improved.

5. Corporate Health Checkup Program

All health issues need to be addressed promptly and smartly with an executive health checkup and corporate wellness program. An executive health checkup program can help companies to diagnose the health conditions and also provide health suggestions if required to an employee. Regular preventive health checkups help to boost the employee health and enhance the emotional and social well-being resulting in improved productivity. Early detection of ailments is possible through an annual preventive health checkup as a delay in detecting certain health conditions on time can lead to fatal results in the future. Corporate managers can also plan pre-employment health checksups to ensure that only fit and healthy employees are enrolled. This program can be customized and can be planned as per the work culture of a company.

The concept of executive health check-ups is an excellent way to induce better health among the work. If you wish to introduce a healthy work culture through wellness programs, health checkup or any other suggested steps, get in touch with the preventive health and wellness solution experts.

The Yearly Master Health Checkup is a wide-ranging health checkup that is used to provide protection from several diseases. Overall, the Master Health checkup is a complete medical package that runs annually.

There are three important factors to consider before you select a Master health checkup plan-

1. All tests should be targeted according to the age, gender, history of health issues, diet, lifestyle, and a number of other factors. 2. The frequency and number of these tests should be according to the international guidelines and can be determined by the available information. These tests should be performed at regular intervals. 3. Avoid any unnecessary tests that can cause any physical harm. This involves mental harm and radiation risks.

Prevention is better than cure

These tests not only detect the symptoms, but also protect you from all the physical pain that you will have to go through if the disease gets severe. If you address the issue early, most diseases can be cured and prevented. It also makes you more functional and energetic. Overall, it helps you maintain your health.

Because it's affordable

Medical care is expensive. But, investing money on preventive health care will save you a lot of money in the future. It is better to spend some money on these preventive measures instead of spending a huge amount of money on treating serious illnesses later.

What to look for?

However, most of the providers fail on many such aspects. First of all, there is no guidance or regulation for the hospitals and diagnostic centers regarding these checksups. Second, a number of tests are no way related to better service. Health screening programs in the developed countries have a set of national guidelines that state the tests to be conducted, the targeted population and the frequency of these tests. Everything is connected so randomly that it beats the point of the screening.

Avoid unnecessary tests

Some diagnostic centers include surveys like X-rays, MRIs, CT scans in their plan which involves radiation. It has a great risk and should be avoided unless there is a requirement of the imaging. Most of the health checkup packages offer these scans even though they do not have any benefit. This might not only be a waste of money but can also be risky. For example, for asymptomatic patients, routine chest x-rays are avoided due to the radiation risk. Also, in the pediatric wellness checks for children, chest x-rays have become a part.

Another group that is targeted with unnecessary checksups is women. The plans include tests like Mammography and Pap test which are meant for women in a particular age group. Doing these tests randomly can be misleading.

So, before you go for the checkup, make sure that you do it from a reputed diagnostic center so that it can provide you with the best plan and does not involve any unnecessary tests. The hospitals of the centers must ensure that you are not going to be exposed to the radiation for unnecessary reasons.

For those in community or public health, the topics in this article will be nothing new-but as busy professionals ourselves, we often find it helpful to be reminded of the basic awards of our chosen fields. It's so easy in our hectic-and very important-drive to complete work tasks that we lose sight of those core values ​​for which we strive.

There are a growing number of evidence-based interventions for use by community and public health professionals to promote health and prevent disease. [Leeman, Calancie, et al .: 2015] These practices have the potential to improve environments, behaviors, and health outcomes in our communities. In order to adopt these practices, however, public health agencies and community partners often need additional tools, strategies, and training to enhance their capacity to improve health outcomes.

The most effective prevention strategies actively engage the communities they are intended to serve. Effective health promotion and health-enhancing social change require communities to identify, plan, channel resources, and take action. The concept that a community is the solution to its own problems is not new. There is considerable support for designing community-based interventions to improve the health behaviors and overall health status of community members. According to Sotomayor, Pawlik, and Dominguez in the journal Preventing Chronic Disease, “These community-based interventions are important because health disparities and the high rate of chronic diseases in minor populations, particularly among those who are poor and lack access to community resources, are not likely to be prevented without them. ” [Sotomayor, Pawlik, and Dominguez: 2007]

The US Office of Disease Prevention and Health Promotion's Healthy People 2020 strides to

Identify nationwide health improvement priorities.

Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress.

Provide measurable objectives and goals that are applicable at the national, state, and local levels.

Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge.

Identify critical research, evaluation, and data collection needs.

Many health prevention and promotion consultants stress the importance that local leaders play in building community health. The Healthy People 2020 toolkit Identifying & Engaging Community Partners, answers the question “How Do You Define Meaningful Citizen Participation?” in this way:

Power to make decisions and affect outcomes

Citizen driven; from the community up, not top down

Proactive, not reactive

Encourages and facilitates broad community involvement

Inclusive, not exclusive; accessible to all

Balanced representation in the participation process; not just major “partners”

Consensus-oriented decision making Compromise; give and take

Opportunities for involvement in all levels of activity, which include creating a vision, planning, prioritizing, deciding, evaluating [ODPHP: 2010]

Building strong relationships with necessary community partners can be time consuming. Facilitating meetings to allow the meaningfulful participation outlined above requires a particular, practiced set of skills. Here's where community health consultant could be extremely valuable. Each community health consultant is different, of course, but in general he or she will have a significant experience with the following tasks:

Developing health education and promotion programs, such as school or community presentations, workshops, trainings, etc.

Writing and formatting health education materials, such as reports, bulletin boards, and visual aids, to address public health concerns.

Developing working relationships with agencies and organizations interested in public health.

Designing and conducting evaluations to assess the quality and performance of health communication and education programs.

Collaborating with community groups and public health officials to identify community health needs and the availability of services needed.

Domiciliary services, or in simpler words, social care services adhere to strict guidelines as per the Health and Social Care Act in 2008 and its further upgrades in 2012. Although the idea of ​​going forward with a social care service is commendable, it is a tough proposal without a doubt.

Putting the best foot forward can ease the overall process once it starts functioning. As a matter of fact, that is just where the guidelines and strictures come in. Registering a domiciliary care service in the UK is a long-tailed procedure. However, here's your thorough guide to it.

CQC Registration:

Every single social care service in the UK requires registration under the Care Quality Commission or CQC. Considering that this is a £ 7.8 billion per annual industry, adherence is sacrosanct. 84% of the sum total functionaries in this field are private or voluntary organizations.

How to Apply for a CQC Registration?

Apply and achieve a Disclosure Barring Service check.

Career history or individual previous employment references.

Register as an organization, a partnership undertaking or an individual.

Comply with the Registered-Manager pre-requisites.

Provide a 'Statement of Purpose,' why choosing to partake in this business sector.

Await registration confirmation and functional green light.

Staff Qualification and Training Recognition:

Every single caretaker personnel in this sector needs to comply with CQC's Common Leads Standards policy. Without this compliance and certification, the individual is not legally fit to function as a staff in UK's adult social care sector. Any person aiming to function as a caretaker needs to complete these standards.

Satisfying Management Personnel Pre-Requisites:

There are multiple other roles which the overall organization needs to maintain for the registration. It's obvious that a social care outfit will not have just a caretaker staff managing the whole setup.

As per guidelines, a care service requires a registered-manager as part of their staff. An RM for this service sector needs to have requisite qualifications.

A prospective RM must have a QCF (Quality Compliance Functionary) Diploma Level 5 via either Management of Adult Services or Management of Adult Residential Services.

For an individual without this diploma, he / she has to complete it within 2 years of the commmentment of duty.

RI –

Although referring conclusively to an RM functionary, RI is the individual responsible for running a care setup. Functions rarely involve directly providing the service in concern. Instead, it concerns managing the end-to-end functionality of the setup.

Financial or Funding Guarantees:

Financing or funding a social care setup incrementally depends on tenders. A setup in this industry sector which is not functioning to its optimal performance can end up as a loss-making venture.

Attracting or inviting tenders requires filling up the Pre Qualification Questionnaire (PQQ). Along with this, there are certain other points of mandatory custody: –

You can obviously see that there are numerous points you need to cover for getting your social care start-up running. A QCS can provide you with each single pointer of these pre-requisites in a single format sequentially to ensure that your initial stages of implementation go through without a single hiccup.

An in-depth procedural knowledge about CQC guidelines, step-by-step methodology and legal aid compilation just an overview of what you will get from a professional QCS service provider.

Referring to the best QCS means that you're solving every single one of these requirements in one go. Furthermore, they will help you in integrating quality assessment audits for optimal functionality of your setup.

Take help from a leading QC provider and get your social care start-up set and running smoothly.

“Prediction is very difficult, especially about the future”.The same is true for cardiac diseases, as it is almost impossible to accurately project when one might suffer from cardiac failure or some other form of cardiac ailment.The recent innovations in cardiac biomarkers aid in diagnosis, risk stratification, and guidance of treatment.They evaluate heart function and most of them are enzymes.

Cardiac biomarkers have evolved as essential tools in cardiology for the prevention, diagnosis, and management of acute myocardial infarction (AMI) and for the diagnosis and identification of heart failure. Due to some stress condition of the heart, these cardiac biomarkers show up in the blood, and the level of biomarkers is usually used to find out how seriously the heart is affected. The various cardiac biomarkers include Cardiac Troponin, Creatinine Kinase (CK), Myoglobin, Lactate Dehydrogenase (LDH), and Aspartate Transaminase (AST).

Are you having some of these symptoms?

· Chest pain or pressure lasting for more than a few minutes

· Pain or discomfort in shoulders, neck, arms, or jaw

· Chest pain that is not getting better with rest or with the application of nitroglycerin

· Respiratory problems, along with vomiting, sweating or paleness, and fainting

· Rapid or irregular pulse.

If you are undergoing all / or some of these symptoms, then you may be suffering from a coronary artery blockage.

How is the market growing?

· Excessive alcohol consumption, smoking, stress, drug abuse, and obesity are augmenting the prevalence of cardiac diseases. According to the Institute for Health Metrics & Evaluation, globally, the number of deaths due to cardiovascular diseases increased by 41% between 1990 and 2013, increasing from 12.3 million deaths to 17.3 million deaths. Here, the number of consumers is also increasing along with.

· Technological advances using cardiac biomarker combinations is another aspect helping this market grow. Using these biomarkers in combination can also enable them to detect traces of protein through highly sensitive assays that help in predicting mortality and reducing healthcare costs.

However, lack of specificity (like Aspartate Transaminase (AT) is not specific for cardiac muscle and thus its detection is not specific to cardiac damage, Lactate Dehydrogenase (LDH) is also not specific in patients having co-morbidities, such as muscle or hepatic disease) is hampering the growth of this market. False positive tests by cardiac biomarkers are also restraining this market.

A report by a market research firm estimates double digit growth rate for Global Cardiac Biomarker Market estimated to become a market worth of USD XX million in 2022.

Due to unhealthy and stressful lifestyle, anyone can suffer from heart failure and coronary blockage nowdays. Early detection of heart failure after the onset of chest pain and low cost of these treatments have boosted the market, thus augmenting the growth of the same.

Hurdles for the Market are:

Issues related to regulatory and reimbursement systems

Way Ahead:

Point-of-care (POC) testing offers the opportunity to provide more accurate and early diagnosis in less time. The technology of POC testing uses whole blood to measure one or more analytes that include cardiac biomarkers. Evaluation of POC testing of cardiac biomarker provides good clinical diagnostic results. POC tests are also growing at a faster rate compared to lab-based tests, and this may drive the market in the future.

Clinical trial management system is a software system used by biotechnology and pharmaceutical industries to manage clinical trials in clinical research.This system maintains and manages performing, planning and reporting functions, along with the relevant information of participants, like contact information, tracking deadlines, and miles.

The system enterprises of protocol development, site selection & trial preparation, subject identification & enrolment, collection, monitoring & processing of data, data analysis & reporting, pharmacovigilance, and submission for review. Data is collected during the process of trials and is stored in the database. The data is then reviewed to decide upon the safety parameter of the drug.

How is clinical trial management useful?

· Real-time Insights into Operations: It is a system that provides a central place for recording operational activity, which offers easy access to important information.

· Stronger Financial management: It supports consistency in budgeting across the enterprise and provides access to all financial information.

· Increased staff efficiency: It reduces duplicate data entry, and therefore only relevant information is present in the software. This saves time for the staff and increases accuracy and consistency of data.

They are experiments done in clinical research to determine medicines or procedures that will / will not benefit the patient. Chronic heart ailments, cancer, diabetes, stroke, and arthritis have long-lasting effects, persistent for more than three months after treatment. Globally, chronic diseases kill more than 38 million people each year. Cardiovascular diseases account for most deaths, approximately 17.5 million people annually, followed by cancers (8.2 million), respiratory diseases (4 million), and diabetes (1.5 million). These four groups account for 82% of the chronic disorder mortalities. New medicines and procedures need to be developed to tackle these diseases. In addition to this, communicable diseases, like Ebola, swine flu, etc. still do not have effective cures. Owing to all these factors, the number of clinical trials performed has increased significantly in the past decade.

Increasing incidences of chronic diseases, increase in R & D to implement localized research programs, increased clinical research outsourcing, and implementation of clinical trials by Contract Research Organizations and Synchronization of Hospital Information System (HIS) with CTMS are some of the factors driving the market growth.

Hurdles for Market: Data security issues, lack of qualified and skilled labor to handle CTMS, increasing rate of clinical trial failure in Phase II and Phase III, and the high cost of customized CTMS are some of the factors hindering the growth of the market.

Way Ahead: The future involves the development of advanced software with high accuracy and efficiency, which will likely provide lucrative opportunities for market growth.

A replacement for solid tumor biopsy could be a reality. A baby could be sequenced at birth so that the same could help to lead a healthy life. For each disease expression, genetic testing plays a vital role for more precise tests through better biomarkers that closely match the actual genetic material. The promise of personalized medicine could only be through better diagnostics for the development of safer and efficient therapies.

Companion diagnostics are tests or assays IVDs intended for the extraction of a patient's genetic and genomic characteristics, which help the doctors and physicians to take better decisions for treatment of a specific indication. The US FDA defines it as a medical device that identifies or determines a condition for a therapeutic product. It helps in providing the most likely and successful therapeutic intervention, by getting the information through patient diagnosis. Many pharmaceutical and biotech companies have focused on cost regulations through the development of companion diagnostics, along with a targeted therapeutic area. For this, there has been a significant rise in the partnerships with diagnostic firms, in order to develop and produce such diagnostics, which are more targeted and effective.

How did companies visualize opportunities in therapeutics development through companion diagnostics?

The first companion diagnostics was launched in the 1980s. Its future success relates majorly on the sequencing and development of personalized medicine. In 2014, Illumina introduced a sequencing system, HiSeq X Ten, which reduced the cost of human genome sequencing to USD 1000 only and was acceptable by many families. The system could transmit almost 18000 human genomes in a year. Companion diagnostics are mainly used in oncology, to scan tumor samples from a large population. Other indications, like the treatment for cystic fibrosis, are also in focus.

The financing environment for diagnostic and research tool companies is also a key factor. Recently, Qiagen collaborated with Centogene, to increase the clinical prediction of rare diseases. Inotrem collaborated with Roche Diagnostics, to develop a companion diagnostic test in the field of septic shock. Although there have been many collaborations, the success rate has been low. For example, Gefitinib, marketed by AstraZeneca, had a disappointing outcome (the drug did not work for 90% of the patients and wave results.) Since then, there are several launches of new therapies. is FoundationOne CDx, by Foundation Medicine, a genomic profiling test for all solid tumors.

Can Companion Diagnostics be a success in the near future?

A report by a market intelligence firm has estimated a CAGR of 35% for the global sharing statistics market and predicted the market to be worth around USD 26 billion by 2022. Owing to increasing demand for personalized medicines and awareness among the population about the same, the industry has recorded huge growth. The rising cases of cancer globally have also been a major driving factor for this market. With companies increasing their collaborations for better biomarkers and diagnostics, there are high opportunities of its applications in indications other than cancer, like in cardiovascular, neurological diseases, etc.

Some of the major hurdles for this market are high costs associated with the development of therapeutics and diagnostic tests. With the high risk of failure in clinical trials, many companies prefer partnerships to minimize their failure rate. The reimbursements issues in different countries also impede the growth of this market.

I recently found this in the MGMA Knowledge Center Forum from a member: “I recently ran across an implementation where the practice administrator threatened to charge each staff member $ 1.00 for every registration error that they out in the system. became terrified of making a mistake. It also was mistaken in interpretation of how required fields needed to be entered. This is akin to a swear jar. How enforceable is this and how legal is it? Just curious of HR repercussions with this concept. ”

Retha Reeves, a consulting administrator in Houston, Texas and a frequent contributor to MGMA forums, replied with “I'll leave the legal question for a lawyer. fear and intimidation is, at best, a disaster? The only successful management style is to work every day towards creating and maintaining a team. in accomplishes. I've always counseled that an important part of management is to help your staff be successful in their roles. , and minimal production. ”

I completely support Retha's point of view. I have been a member of teams with automatic leaders and those who listened to and support the team members. My own experience is that those teams who meet Ms. Reeve's criteria function best and achieves the best outcomes for patients and clients. I am currently a member of a team that is building a program to prevent falls in elderly people in the community. This team is a part of the Calvin College Rehabilitation Services in Grand Rapids, MI. Recently the team met to fill in a work plan template that included the key activities and how to measure them. Each team member freely contributed ideas for the plan and asked questions to clarify an idea if needed. A great deal of planning was accomplished and I left feeling like my contributions were valuable and welcomed.

The American Medical Association also sees teamwork as benefitting practices by increasing productivity and patient satisfaction as well as employee satisfaction. The success or failure of a practice depends upon the practice's culture. The AMA believes that practices should focus on improving team culture continuously. They have roled out on their web site a free online module as part of its STEPS Forward collection that can help practices build a positive team culture. You can find it at by clicking this link .

In the module the AMA lists ten steps for building a strong team culture:

1. Diagnose the current state of your team culture

2. Discuss the results and brainstorm possible improvements

3. Create a staff compact as a group

4. Create opportunities for team communication throughout the day

5. Meet regularly

6. Strengthen the team by focusing on individual development

7. Get to know your team members

8. Teach leaders to be mentors, not managers

9. Create an environment that supports continual learning

10. Engage patients

The module begins by asking practice administrators to assess the culture of their practice by having each team member take an anonymous survey that is provided online. A couple of the questions are (1) Team members say what they really think and (2) All team members participate in making decisions about the work of the team. The module begins with this assessment because it is understood that “you can not move forward unless you know where you have been”, a common wisdom.

After the staff takes the survey and the results are analyzed by a trusted staff member or a third party quality expert, leaders of the practice should have team meetings that discuss how to move forward. The first thing task for the team meeting should be to write a goal that states the purpose of the meeting and future meetings. It should center on building a culture that values ​​teamwork.

The 'culture team' in the first meeting can brainstorm ideas of how to improve the culture of the practice in concrete ways that can be implemented by the leaders and the rest of the staff. I believe that it would be a good idea to use the survey again in the future to see what growth has occurred and to make adjustments that will lead to even better teamwork.

One of the benefits of improving teamwork is that the team can work together more effectively to improve the practice's processes. Team members can meet to focus on processes that effect patient outcomes, such as processes that improve patient satisfaction and patient engagement. Having practice staff involved in improving processes such as these will lead to markedly better results than if only one or two people are involved. Team members can generate ideas, for instance, in improving patient engagement, and then design a team member to own the process of implementing their ideas. The results should be measured and reported back to the team.

The development of teamwork among clinicians is taking place in colleges across the US Colleges have created courses that support interprofessional practices. This is the IPE movement. In September 2017 Grand Valley State University in Michigan is hosting a two day conference devoted to Interprofessional Practice, Education and Research. One of the focoes this year of the conference will be telehealth. John Scott, Medical Director and Telehealth Associate Director of the Harborview Medial Center at the University of Washington will be a keynote speaker. One of the breakout sessions at the conference will focus on the collaboration of graduate students in healthcare with Answer Health on Demand, a local telehealth provider in Grand Rapids.

As you can see there are many supporters of the development of teamwork in the healthcare field. The benefits of developing a strong team culture are many, including hitting the Triple Aim of healthcare-better care at a lower cost with improved patient satisfaction. Focusing on teamwork at a practice site will help in the transition to value-based care.

The debt goes on, should the government be responsible for providing our health care?

There are many arguments for and against national healthcare.

At one time, everyone was responsible for their own health, there was no insurance. In that day and age, medical care was a lot less expensive than it is today, even taking into account the rate of inflation over the years.

The rise in cost has in part is due to all the new technology available today, but to a large degree, the rising cost is due to increased demand.

Because of the change in our national mentality, in a large part due to negotiated union contracts, everyone thinks their health care is free. Most have come to believe it is a right, a right no one pays for.

I'm a firm believer that affordable healthcare should be available to everyone.

However, because of the present system, very few people realize the cost of health care, and because it is usually free to them, they go to the doctor for every little sniffle they get. Many visits are unnecessary and costly. People go to the emergency room for a skinned knee, or a splinter in their hand, these emergencies could have taken care of at home.

It has become “fashionable” to go to the emergency room.

Health insurance should be paid for by the individual. If each individual was responsible for their healthcare, they would become more knowledgeable on what “works” and what does not.

Most companies that provide health insurance allocate a certain amount of wages for the payment of benefits including health insurance, either they tell the employee or not.

The individual employee should have made aware of this, that money should be allocated to the individual so they can purchase their health care on an individual basis.

Thereby eliminating any corporate influence the company could exert on the insurance company, and it would open the insurance industry to more competition, that is always a good thing.

That would enable the individual to have more control over his health care and ensure his right to have or not have insurance.

In some cases, when both spouses work and are covered by their individual company insurance, both companies are providing and paying for health insurance and only one health plan is needed.

Therefore, money is wasted by the couple because they do not use the insurance provided by one company. If the money was allocated to the employee, he or she could decide how to best use the money in a way that would benefit the couple instead of the money being flushed down the drain.

It would make the individual more responsible for his own health and welfare, and it would be his choice to have or not have health care.

If he chooses not to have health insurance, then he would be liable for any charges incurred, and pay the consequences for not having insurance.

By cutting down on the demand by eliminating people going to a doctor or emergency room without necessary, then the cost would normally come down, and people would find the alternative, less expensive, better forms of treatment.

Of course, there will always be an element of society who are unable to care for themselves and they should be provided for, but there are far too many people abusing the system.

The only way to prevent that is for people to be in charge of their own health. Regardless of what you believe, no one, including the government will look after you like you will.

This is America, our country was founded on the idea of ​​the individual being able to make his or her own choices concerning how to run their lives, it's time we returned to those ideals and get government out of life management.